Arthroscopic Technique for Medial Epicondylitis: Technique and Safety Analysis

Zonno, Alan J.; Manuel, Jennifer; Merrell, Gregory A.; Ramos, Paul; Akelman, Edward; DaSilva, Manuel F.

doi:10.1016/j.arthro.2009.09.017

Cited by 42 publications

(29 citation statements)

References 22 publications

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“…Presently, there are no studies assessing the use of arthroscopy. One cadaveric study assessed the proximity of the ulnar nerve and the medial collateral ligament complex to the region of debridement, demonstrating a mean distance of 20.8 mm from the ulnar nerve and 8.3 mm from the anterior bundle of the medial collateral ligament [20]. Arthroscopic surgery is likely, at present, to remain experimental given the close proximity of these structures.…”

Section: Operative Managementmentioning

confidence: 99%

Tendinopathies Around the Elbow Part 2: Medial Elbow, Distal Biceps and Triceps Tendinopathies

et al. 2014

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In the second part of this review article the management of medial elbow tendinopathy, distal biceps and distal triceps tendinopathy will be discussed. There is a scarcity of publications concerning any of these tendinopathies. This review will summarise the current best available evidence in their management. Medial elbow tendinopathy, also known as Golfer's elbow, is up to 6 times less common than lateral elbow tendinopathy. The tendinopathy occurs in the insertion of pronator teres and flexor carpi radialis. Diagnosis is usually apparent through a detailed history and examination but care must be made to exclude other conditions affecting the ulnar nerve or less commonly the ulnar collateral ligament complex. If doubt exists then MRI/US and electrophysiology can be used. Treatment follows a similar pattern to that of lateral elbow tendinopathy. Acute management is with activity modification and topical NSAIDs. Injection therapy and surgical excision are utilised for recalcitrant cases. Distal biceps and triceps tendinopathies are very rare and there is limited evidence published. Sequelae of tendinopathy include tendon rupture and so it is vital to manage these tendinopathies appropriately in order to minimise this significant complication. Their management and that of partial tears will be considered. INTRODUCTIONThe tendinopathies to the common flexor origin, distal biceps and distal triceps occur much less commonly than lateral elbow tendinopathy. The second part of this two-part review article focuses on these tendinopathies and the current best evidence to manage them.

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Section: Operative Managementmentioning

confidence: 99%

Tendinopathies Around the Elbow Part 2: Medial Elbow, Distal Biceps and Triceps Tendinopathies

et al. 2014

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“…These may encompass open procedures, percutaneous release, and arthroscopic repair of the common flexor tendon. 1,21 Concomitant ulnar nerve issues may be present; 20% to 24% of refractory cases of medial epicondylitis have been cited as requiring a concomitant ulnar nerve release. 19 For the past decade, we have been addressing refractory medial epicondylitis as a surgical lesion involving a discrete degenerative tear, typically located at the flexor carpi radialis/pronator teres origin.…”

mentioning

confidence: 99%

An effective approach to diagnosis and surgical repair of refractory medial epicondylitis

Vinod

Ross

2015

Journal of Shoulder and Elbow Surgery

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Identification of weakness on pronation is a reliable physical examination finding for determining clinically significant pathologic changes in patients with medial epicondylitis. Débridement with restoration of the flexor-pronator origin is an efficacious procedure. In this large series of patients, surgical repair with aggressive rehabilitation was shown to be reliable and safe in restoring function and relieving pain in recalcitrant cases of medial epicondylitis.

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“…Cadaver studies by Zonno et al [ 88 ]. show that arthroscopic treatment of medial epicondylitis can be safety performed with low risk of injury to the ulnar nerve or the MCL.…”

Section: Resultsmentioning

confidence: 99%

“…Visualization is established through a lateral portal with instrumentation through a medial portal. Zonno et al describe using a switching stick to establish a second medial portal that is more posterior and medial to provide improved inspection of the medial aspect of the elbow joint [ 88 ]. The degenerative capsule and fl exor-pronator tendon is debrided until the MCL is visualized, which lies just distal to PT and FCR.…”

Section: Arthroscopymentioning

confidence: 99%

Essentials In Elbow Surgery

Antuña¹,

Barco²

2014

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Arthroscopic Technique for Medial Epicondylitis: Technique and Safety Analysis

Cited by 42 publications

References 22 publications

Tendinopathies Around the Elbow Part 2: Medial Elbow, Distal Biceps and Triceps Tendinopathies

Tendinopathies Around the Elbow Part 2: Medial Elbow, Distal Biceps and Triceps Tendinopathies

An effective approach to diagnosis and surgical repair of refractory medial epicondylitis

Essentials In Elbow Surgery

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